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Case Study

Opium: My Understanding and a Case
Dr Vishpala Parthasarathy

Introduction: The case in the ICR symposium cum-workshop held in April 2000, brought out the Opium picture very well.

Then again the structures made by Dr Navin made Opium very vivid. We decided to make a study of Opium as a remedy. I felt that a further study of Opium, the remedy, would complete our understanding and stand us in good stead.

So I added to the above, my understanding of the remedy illustrating it with a case. By a fortunate coincidence, on 5-7-2000, we received Dr Rajan's new book for review, so from that we are adding his case of opium. This study then really becomes quite exhaustive, covering various view points of that one remedy, which is known not very well and used quite infrequently in practice.

After this, I do believe that none of us will ever miss a case of Opium. This report should have been included in the last issue, but it ran into difficulty of space.
If this is found effective we will try to give such a study in every issue.

Opium - Keywords:
Energizer and narcotic
Opium is the most commonly used narcotic. It became popular in the 60's when the hippie culture was at its peak, and the beaches of Goa were strewn with these flower children. It was being used to escape reality and tensions of life. It takes away the pain of living. Its main components Morphine, Apomorphine and Codeine - all of them being the armamentarium in modern medicine for pain relief.

Primary Effects: First stage of excitement is a state of great happiness - where nothing else exists except me and my feelings of greatness and content. I float; I am on top of the world, literally. I achieve what I want and I sleep the sound sleep of the unconcerned. I want for nothing, I don't ail. I am free from anxiety.
Loquacity and hallucinations. Flushing of face, a false plethora, giving it the false healthy look. Increased heart rate - Euphoria, Excitement and Sleeplessness.

Secondary Effects - Stupor: Suppressed nerve centers. Fear, fright, sluggishness, loss of power, drowsiness, loss of consciousness jerking paralysis. Headache, nausea, vomiting, giddiness; lethargy, uncontrollable desire to sleep, from which he can be roused only with the greatest difficulty. Pupils contracted, face cyanosed. Itching all over. Pulse and respiration normal.

Tertiary Stage: Narcosis. Deep coma from which he cannot be roused. Muscles relaxed, reflexes lost. Secretions completely suspended except that of skin - which turns cold and clammy. Pale face, livid lips and drooping jaw. Conjunctiva - infected. BP falls. Pulse low volume, small, and compressible. Respiration slow, laboured 2-4/min. Even at this stage, recovery is possible. Later only Cheyenne stokes breathing and death. Wildly dilated pupils towards the end. Tetanic convulsions. Lack of sensibility. Bladder, rectum sluggish; do not react, hence retention of urine and constipation. No secretion leading to dryness everywhere.

Depression - extreme = coma with pinpoint pupils with moist skin. Cyanosis. Boger: negative torpid state.

Absence of pains. Absence of suffering, Absence of secretions. Absence of reaction. Absence of moral sense, discharges. Absence of eruptions in eruptive fevers. Absence of respiration, as if dead. Paralysis of bowels, no message to brain- dry ball-like stool, scabalous stool.
AF fright and joy.
Therefore the remedy may prove useful in so-called incurable cases.

Commonly Indicated Diseases:
Headaches and migraines
Convulsions; Puerperal.
Amenorrhoea from fright.
Apoplexy. Paralysis.
Paralysis of bladder, tumours. Fibrosis.
Insomnia. Narcolepsy.

I once had a patient with the total euphoric state, what I call as a pathological state of Opium. He lived in a simple house, where his wife had to slog to make both ends meet. But he was oblivious to this; he talked about his grandiose schemes of making it big. His schemes neither took off nor materialized. He left home every morning dressed in his Sunday best, while his wife and children managed on whatever she could eke out of giving tuitions. But as is the case with the world, he always found some fool ready to listen to him and part with money.

Not for him the arduous task of toiling for his upkeep, which he left to his poor wife. Emotionally he was completely divorced from her. He could carry on his life's needs from these amounts shelled out by the gullible folks. By the time one fool or victim woke up, another was ready for the slaughter. As the saying goes there is no dearth of fools in this world, as long as he did not try to fool all the people all the time, but took one at a time. He loves people and collects people like the proverbial Red Indian collects skulls.

His motto was: the more people you know, the more work you can get done through contacts!! So his daily aim was to meet 1 or 2 new people. Then again, he loves to talk and for this an audience is a must - the larger the better. And name-dropping got him even more contacts. After all, if he is a personal friend of Dr Vishpala Parthasarathy and has lunch and dinner at her house "regularly", (no one can know the truth) then more doors will be opened to him on trust.

And such a sweet talker this man is, that it would be difficult to imagine that there was no substance to his talk. Even when found out, he could move on easily, because he did not have an iota of shame. Shamelessness is an important trait of Opium.

Once, from "the goodness of his heart" he helped me organize the largest event in my life - the Book Release of my mother's 4 books. After the event he presented me with a big bill. For all the work which he had done, ostensibly to help from the goodness of his heart, he ran up a taxi bill of Rs 5,000! Not for him the travel by public transport - after all, Opium is king. All his actions are larger than life.

When he talks, it is never normal, always boastful: in Saudi I used to have breakfast of Badam, and in Delhi breakfast always at Narula's. And when was he in Saudi? Not yesterday or last yr but in 1984, a full 10 yrs ago! And what did he do? And why did he leave? " I was in Saudia, but I hated it, so even though they offered me Rs 25-30 lakhs (don't forget this was 15 yrs ago, when large salaries were not even dreamt of, leave alone formulated and given) I did not, because I cannot be bought with money". (Truth was that he was thrown out!)

[As an aside, I want to quote one more such a patient-a distant relative who was exactly like this; even till the time (and after) he lost his business and went into bankruptcy, his schemes never failed!! He started with borrowing money from my mother; 20 yrs later he was still borrowing- now from the daughter - me. And the money never came back, except in small amounts when he needed bigger amounts the next time round. But till the end his grandiose image of himself never dimmed. He has passed on this inheritance to his children - who have no money but will still eat out at a restaurant, at least once a week. One sensitive child took to drugs and eventually committed suicide. And his poor wife struggled all her life counting pennies to make ends meet. Even today, though she is comfortable, she can never spend money - a habit of a lifetime dies hard!]

Coming back to our patient:
Pt studied M Sc and PhD (Liver Cirrhosis) at KEM, and then later started Pathology Lab at Ramakrishna Mission and Chembur. He lived in Chembur and all patients were like family to him, so he never charged them. All doctors cheated, patients would complain to him. He begged consultants not to forget ethics! All this did not happen, so he gave up his lucrative practice of 30,000/- a month, because he did not like to work in an unethical environment. Continued to do social work - President of Chembur Club and so on.

Then he went to Saudi. That is another story.
After he returned from there, it was the end of the line for him, work- wise; because he became a man of leisure and yarns. Every month he was on a new hype - a project to run emergency hospital on wheels, Helicopter emergency services, etc, 2 yrs later when I met him again, the scheme was a little more mundane, helping his daughter set up an import business in leather. He was going to USA to finalize the details. When I met him 15 days later he was back from his trip with all details in place. I suspect he never made the trip!!

Anyway, after my Book Release, I got on with my daily routine, but he would park himself in my clinic or my house everyday. As you know, I am a workaholic and genuinely had no time. So finally the only way I could deal with him, was to let him wait in the antechamber. The waits were eternal and I figured that such hints would penetrate the thickest of skulls. It took a full 2 months of these tactics to show 50% results and the remaining 50% took a rude talking to, before he vanished 100%. Before vanishing, he tried the oldest trick in the book; he came to me as a patient! I anyway had been looking for an opportunity to give him Opium, so I happily took his case, Free of course, to which his comment was "I would have offered to pay you, but will not, since I know you will never take it" !!

On 29-9-95 he got a backache after a jerk in the auto; worse first motion or bending to remove shoes. While taking history, since I have seen him take too much time to get out of car, I asked him how his knees were, and he said absolutely fine! He could jog everyday from Juhu and back.

"Lt shoulder pains sometimes, but goes away if I concentrate my mind for 1 min". Once earlier he had fractured his lt. arm, slipped on moss, it was hanging in 2 parts and he let it be set without Anaesthesia. This was in 1978, but he could conjure up the picture as if it was yesterday.

Mind Symptoms: 
I will put down in a nutshell what all he told me "for me, my head rules, I am never egoistic, never jealous, I hate hypocrisy. I feel sorry for others when I am angry also. That must be a lacuna in me. I have no superiority or inferiority complex, I am very frank, very principled, can always judge by being very neutral. I can understand a person almost 90% in just one meeting, and it rarely turns out to be wrong. I hate cheating in any form and then I get very angry and go to any lengths even to kill. I can just blow up money. (This at least was true!). I love nature. (Misfit is the word in this whole monologue) Love enjoyment, outing, drink and hotels.

On questioning he said: "I give my wife daily Rs 20 for expenses of house and children and Rs 40 for myself."

About Wife: " She is simple, why divorce her, why break up? Actually her father was my friend and he insisted on giving her hand to me. He was a personal friend of Rajiv (Gandhi that is) and that remained in spite of all the ups and downs. When I was in Saudi, I went to Mecca. God arranged it. I had many discussions with the religious heads there. In 1984-85, the bosses in Saudi offered me Rs.50 lakhs / mth but I refused and returned back to India. (They all actually cried". (The best part is that all this, he believes, really happened. The delusion in Opium is so strong that they make up and actually live in this make-belief world. His memory is so good. He talks of everything as if it happened yesterday. And you can see the inconsistency in his stories!)

About Childhood: "Fear never! Not even of snakes" (though when he came to my house he was scared of my dogs!) Weeps very easily. Very sensitive to others. Sleep very good; never dreams.

"At 1 yr I had fear of going to the 1st floor. Went whistling and quickly put on the light, conquered that fear. I was born a confident child. Always go deep to understand things better. Like all realized souls".

Some Generals: Wt: 70 kg Perspiration3, running down, appetite3, loves pan, tobacco.
Appetite Voracious. Loved food, sweets, puddings, pickles, in Saudi- only badam, pista, kaju. Tobacco 25-30g/d; beer, whiskey. Thirst 10-12 glasses water per day.


SR I 935

Speech bombastic

SR I 713


SR I 294

Delusion: Great person he is

RM 1023


RM 1023

Deeds, feels as if he could do great

RM 1034


RM 1037

Eccentric behaviour

SR I 115

Boaster, Braggart

SR I 706


SR I 707

Lies, never speaks the truth, does not know what she is saying

SRI 437


RM 1042

Exaltation of fantasies, imaginations

RM 1043

Fantasies, vivid, lively

RM 1085

Moral feelings, want of

RM 1086

Neglects his own business

RM 1087

Plans, making many

SR I 897


SRI 909


SRI 101


SRI 471

Fancies pleasant

SRI 472

Fancies vivid, lively

SRI 415

Dream, as if in a

SRI 143

Clinging, grasps at others

SRI 609

Indifference, apathy

SRI 441

Escape, attempts to

SRI 942

Speech nonsensical

SRI 537

Foolish behaviour

SRI 54

Antics plays

SRI 573


SRI 593

Ideas abundant

SRI 943

Speech, prattling Fastidious about self and clothes. Spendthrift on himself.

RM 534


Most of the rubrics are covered by opium, and even when some are not the general gist is certainly covered.

Follow Up:
29-9-95 Backache very severe could barely move. I gave him a dose of Opium 1M.
7-10-95 65-70% better
10.10.95 No pain. Now I wanted to try to see if his tobacco consumption could be reduced. Opium 10M - 1dose
10-11-95 I felt there was decrease (I asked his panwala about his daily consumption!) but he did not report that. After that no medication was given, as there was no opportunity. I then lost touch with him for 4 yrs, He surfaced last yr, but I could see he was much the same. He was carrying on in his usual style, this time to go abroad to set up his daughters' leather line!